While most people might expect a simple "yes" or "no" answer to this question, the truth is far more complex. Whether or not liver damage from alcohol can be reversed depends on several factors. However, one thing is certain, no matter what the severity of damage is the first step is always to stop drinking.
The human liver is a truly remarkable organ. It is the largest organ in the body, weighing in around 3.5 pounds, and it is the only organ in the human body that is capable of repairing itself by generating new liver cells from healthy cells that remain after the liver has been damaged. But the extent of the damage is critical in determining whether or not the liver will be able to heal.
The Early Stages Of Damage
Most liver damage is caused by heavy drinking that occurs regularly over a long period of time. So it may take years even for the earliest signs of liver damage to become apparent.
The first stage of liver damage is the fatty liver. A fatty liver occurs when large drops of fat, made mostly of triglycerides, a type of fat normally found in the blood, accumulates in the liver. Over time, this can cause the size of the liver to increase threefold and can cause pain and tenderness in the abdomen.
However, because one of the jobs of the liver is to process fats in one’s diet, once the liver is no longer overloaded by processing alcohol, it can quickly dispose of the fat cells and return to normal. The short-term prognosis for someone with a fatty liver who stops drinking is quite good, but if a person continues to be a heavy drinker, further damage will result. In fact, more people develop cirrhosis who have fatty liver changes than those who do not.
Alcoholic hepatitis, like it's viral counterpart, inflammation of the liver. In the case of alcoholic hepatitis, the inflammation is caused by long term heavy drinking. Often a person can have alcoholic hepatitis and show no signs or symptoms, which can make diagnosis and treatment difficult. If a person does have symptoms they may not appear until the hepatitis is more severe and may include:
- Abdominal pain and tenderness
- Loss of appetite
- Nausea or vomiting
- Abdominal swelling
- Jaundice (the yellowing of skin and eyes)
- Mental confusion
Whether or not the liver damage caused as a result of alcoholic hepatitis can be reversed depends largely on the severity. As the hepatitis progresses it can lead to fibrosis, the forming of scar tissue in the liver. If this happens the damage may not be reversible depending upon how extensive it is. The long term prognosis for someone with alcoholic hepatitis is highly variable as a result.
Cirrhosis of the liver is very serious. This is what happens when liver tissue dies and the liver structure itself begins to change. Cirrhosis causes the liver to shrink and harden, making it extremely difficult for it to do its job. Pressure in the main blood vessel of the liver, the portal vein, may become dangerously high and can cause blood to back up into other vessels and into the spleen which can cause blood platelets to be destroyed. When this happens toxic substances that would normally be filtered out of the blood by a healthy liver will accumulate in the body and the clotting factors that would normally stop a person from bleeding aren't formed. All of this can add up to death.
Cirrhosis is not reversible. The only hope that a person with cirrhosis has is that enough of their liver remains healthy enough to keep them alive, or they will need a liver transplant. Unfortunately, many doctors and hospitals are reluctant to perform transplants on people with cirrhosis caused by heavy drinking out of concern that they won't properly care for themselves after the procedure. Transplant recipients must follow a strict care regimen after their transplant or they will die.
A heavy drinker can have cirrhosis for many years without knowing it. It is progressive, which means that if the person doesn't stop drinking, the cirrhosis will continue to get worse. However, even at this stage, if they stop drinking and abstain from drinking for the rest of their lives, they may survive if enough healthy cells exist.
Further Severe Complications
Once a drinker has cirrhosis, they are at an elevated risk for developing a number of serious complications. These include:
- Liver Cancer- while it is one of the more common forms of cancer, and it is treatable, the success of treatment depends upon early detection. At later stages it becomes difficult to treat and can result in death.
- Pancreatic Cancer- pancreatic cancer is one of the most difficult to treat because it is often advanced by the time it is diagnosed. Research has shown that those who consume more than three drinks per day over a long period of time are at a greater risk of developing pancreatic cancer.
- Ascites- excess fluid in the space between the tissues in the peritoneal cavity. This can result in severe distention of the abdomen and occasionally a spontaneous rupture.
- Kidney Failure
- Esophageal Varices- this is the enlargement of the very small blood vessels in the esophagus and at the top of the stomach. When the pressure on the portal vein becomes high enough it can cause ruptures in these superficial blood vessels resulting in bleeding in the esophagus and stomach.
In the end, the most severe complication associated with heavy drinking is death. However, if a person quits drinking and their liver damage is discovered early, it can be reversed. But prevention is always the best medicine. Indulging responsibly will mean that one never has to wonder if their liver damage is reversible.